Increased quality of life predictive factors after cardiac resynchronization therapy in heart failure patients.

OBJECTIVE: This study aimed to investigate the effects of cardiac resynchronization therapy (CRT) treatment on clinical and echocardiographic findings, the quality of life (QoL) in heart failure (HF) patients, and to identify possible predictors of improvement in QoL. PATIENTS AND METHODS: A total of 97 patients (73 males and 24 females, mean age 62.8±10.6 years) with HF who underwent CRT implantation were included in this study. Demographic characteristics, laboratory findings, transthoracic echocardiography, and quality of life assessment of the MOS 36- Item Short-Form Health Survey (SF-36 score) data were recorded at baseline, and 6 months after CRT. Baseline and 6th-month data were compared. The data of groups with and without improvement in QoL were analyzed, and predictors of improvement in QoL were determined. RESULTS: According to the criteria for response to CRT, we observed good response at 6 months follow-up in at least two-thirds of heart failure patients. Significant improvement was observed in the SF-36 score of 67 patients who underwent CRT, and the procedure was considered successful in terms of improvement in QoL in these patients. In this group, baseline ejection fraction (EF), tricuspid annular plane systolic excursion (TAPSE), and right ventricular lateral peak systolic velocity (RV-lateral-S) values were significantly higher. TAPSE and RV lateral-S values were found to be significant in predicting the improvement in QoL after CRT [OR: 1.77 (1.00-3.14), 2.61 (1.02-6.69), respectively, p<0.05]. The cut-off values of these predictive factors were found to be 15.5 for TAPSE and 9.65 for RV lateral-S. CONCLUSIONS: In our study, we found that TAPSE and RV Lateral-S were predictors of improved quality of life in patients who underwent CRT. Routine evaluation of right ventricular functions before the procedure can provide significant improvement in quality of life as well as clinical symptoms.

Relationship between vitamin D deficiency and thrombus load in patients with ST-elevation myocardial infarction.

OBJECTIVE: Clinical studies detecting the increase in thrombotic events with vitamin D deficiency note the relationship between vitamin D and thrombosis. This study aims at evaluating the relationship between serum vitamin D levels and coronary thrombus burden. PATIENTS AND METHODS: We retrospectively evaluated 77 patients with ST-elevated myocardial infarction (STEMI). Serum vitamin D levels, degree of coronary thrombus, Thrombolysis in Myocardial Infarction (TIMI) frame count and the extent and severity of atherosclerosis in coronary arteries were also measured in all cases. Patients were divided into 2 groups, according to thrombus load. RESULTS: The rate of vitamin D deficiency in the study population was 79.22% (< 20 ng/mL). Vitamin D levels were significantly higher in patients with a mild thrombus load than in patients with a severe thrombus load (16 vs. 13.95 p = 0.018). Gensini scores were significantly higher in patients with a severe thrombus burden than in patients with a mild thrombus burden (42 vs. 54.5 p = 0.014). There was a low negative correlation between vitamin D levels and thrombus burden classification grades (r = -0.304, p = 0.007), Cx TIMI frame counts (r = -0.402, p < 0.001), and RCA TIMI frame counts (r = -0.479, p < 0.001). There was a moderate negative correlation between serum vitamin D levels and LAD TIMI frame count (r = -0.507, p < 0.001). CONCLUSIONS: The results of our study showed that low 25(OH)D3 levels are an independent predictor of high coronary artery thrombus load and post-procedural TIMI frame count increase in patients with STEMI undergoing primary percutaneous coronary intervention.